Saturday, March 17, 2007

To kiss for life.

A monument in American literature is Ernest Hemingway’s novel “For whom the bell tolls”.
Together with Thomas Wolfe’s “You can’t go home again”, they are symbols of the dynamic society the USA was for literature and the arts last century.

In Ernest Hemingway’s novel “For whom the bell tolls” it is described by the Spanish woman Pilar how one can smell death.
According to Pilar, a person who is going to die soon, has a smell.

The protagonist of the book, Robert Jordan, an American involved in the fighting of the Spanish Civil War, doesn’t believe Pilar’s claim.
He asks how exactly that smell is.
Pilar replies: “Go down the hill in Madrid to the Puente de Toledo early in the morning to the Matadero and stand there on the wet paving when there is a fog from the Manzanares and wait for the old women who go before daylight to drink the blood of the beasts that are slaughtered. When such an old woman comes out of the Matadero, holding her shawl around her, with her face grey and her eyes hollow, and the whiskers of age on her chin, and on her cheeks, set in the waxen white of her face as the sprouts grow from the seed of a bean, not bristles, but pale sprouts in the death of her face; put your arms tight around her and hold her to you and kiss her on the mouth and you will know the odour of death.”

This chilling excerpt comes to one’s mind when learning of the publication of a report in the medical journal Lancet by Japanese researchers last Thursday.
Those Japanese researchers are bringing us wonderful news and it is even confirmed by Dr. Gordon A. Ewy of the Arizona College of Medicine and Dr. Paul E. Pepe, head of the emergency medicine department at the University of Texas.
What is this fantastic news?

Imagine you are travelling in a train.
Not many people are in your compartment.
Just a couple of young people and an old woman.
Suddenly, the old woman becomes unwell.
She collapses, falls down, and might die.
She could be saved but you need to apply CPR.

CPR is cardiopulmonary resuscitation.
You have to tilt the head of the old woman back and listen for her breathing.
If she is not breathing normally, you pinch her nose and cover her mouth with yours and you blow until you see her chest rise.

Research has found that when somebody needs CPR, three-quarters of the bystanders decline to perform it.
They say they fear infectious diseases but probably they also do not feel comfortable to have a mouth-to-mouth contact with a complete stranger.

Now these Japanese researchers found, overturning a century of conventional medical wisdom, that simple chest compressions without mouth-to-mouth ventilation saves twice as many heart attack victims as the traditional CPR.
“Most people do better with compressions only”, said Dr. Paul E. Pepe.
How did they come to these fabulous conclusions?

At the Surugadai Nihon University Hospital in Tokyo Dr. Ken Nagao and his colleagues studied 4,068 adult patients who had a heart attack in front of witnesses.
We may wonder how they achieved this remarkable feat but the result of the research showed that the ones who received compressions only fared twice as well.

So, next time in the train and another old woman collapses, we can be relaxed.
We only need to apply compressions to her chest.

However, do not think we are free now of ever to have to blow our air into the mouth of complete strangers.
Victims of drowning still require conventional CPR.
If it is really an issue for someone, to touch mouths with strangers, stay away from the beach and the swimming pool.

To learn more about CPR, click on

To learn the guidelines for CPR from the American Heart Association, click on

To read the article in the medical journal Lancet about CPR, click on

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